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Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our CP-NORTH HILLS HEALTH CENTER facility. This job is ON - SITE. FTE: 0.400000 Standard...

Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

Job Description Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and...

Description Location: UCHealth Anschutz Inpatient Pavilion - Aurora Department: Virtual Health Center - Quality program This position is an onsite role and does not offer a hybrid or remote...

Overview The Patient Clinical Services team is a centralized nursing service where the Patient Clinical Services RN implements best practices in patient care and coordination for participating Primary Care locations by...

Pre-Access Utilization Management Registered Nurse Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance clients. This person will be responsible for...

A leading technology services firm is seeking a Quality Assurance Registered Nurse for a 100% remote contract-to-hire position based in Atlanta, GA. The role entails performing quality assurance reviews, ensuring compliance with clinical...

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help...

Job Description: • Participates in the development and ongoing implementation of QM Work Plan activities. • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...

RN Care Review Clinician The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

Registered Nurse, Quality Assurance Reviewer The Registered Nurse, Quality Assurance Reviewer will work in conjunction with the Quality Manager and will be responsible for completing quality reviews for the Clinical Services and Provider...

Job Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern...

RN - Utilization Review Nurse | 3+ Years of Experience | Remote in IL | Contract Walker Healthforce is seeking a RN - Utilization Review Nurse with 3+ Years of Experience to support a Healthcare Payor Client based out of IL.

A leading healthcare institution in Baltimore seeks a full-time RN/Ambulatory to work in the Central Nursing Department. The RN will play a crucial role in triaging patients, providing care management, and ensuring quality patient education.

A major healthcare provider seeks a Transitions of Care RN to deliver patient education across programs for chronic disease management. This role involves conducting assessments, coordinating health-coaching plans, and monitoring the effectiveness...

Are you an RN looking to step into a role where your skills, curiosity, and initiative truly shine? At Central Ohio Urology Surgery Center, we're not just any ASC; we're nationally recognized for excellence and proud to lead the way in...

A healthcare organization is hiring a skilled Nurse Advice Line Clinical Triage Nurse for a part-time position. The role involves performing clinical triage and coordinating care based on inbound calls. The ideal candidate must hold an RN License...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic...

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover...

Where You'll Work From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20...

A healthcare management company is seeking a Care Manager in Hartford, CT, to provide telephonic care management and support to members. The ideal candidate will have a current RN license, strong motivational interviewing skills, and 3-5 years of...

Job Summary: The Clinical Nurse Specialist is an advanced practice nurse who functions in the role of expert clinician, educator, leader, consultant and researcher. In collaboration with the healthcare team, the CNS...